Biomarker landscape in advanced NSCLC: insights from a national prospective registry
- PMID: 40749260
- DOI: 10.1016/j.lungcan.2025.108680
Biomarker landscape in advanced NSCLC: insights from a national prospective registry
Abstract
Objectives: The determination of actionable genes is a necessity in lung cancer for proper care practice. The Spanish Lung Cancer Group (Fundación GECP) has performed an exploratory analysis of this aspect, specifically in stage IV non-small cell lung cancer (NSCLC).
Materials and methods: The Thoracic Tumor Registry (TTR) is a Spanish prospective, observational cohort study. At the time of data extraction (March 2024), 27,399 patients were enrolled from 82 hospitals.
Results: There were 13,583 patients with stage IV NSCLC. The analysis of at least one tumor marker was performed in 85.7 % of non-squamous and 62.8 % of squamous patients (p-value < 0.001), with differences between autonomous communities. In the non-squamous population, the three most frequently analysed markers were EGFR (77.3 %), ALK (66.1 %) and PD-L1 (56.3 %). Biomarker profiling has undergone a more pronounced and extensive development in squamous histology in recent years. Molecular determinations that do not have a generally approved targeted therapy have also increased. Biomarker testing in patients with ECOG PS 2 is lower compared to ECOG PS < 2 (77.6 % vs 82.6 %, p-value < 0.001). Sub-analysis shows rates also vary by hospital size.
Conclusion: The analysis of tumor markers in stage IV NSCLC patients continues to increase in Spain, at the same level as in Europe o USA, despite the absence of national plans. There are clinically guided determinations that are rare in squamous histology but have an appreciable percentage of positivity. Even in patients with ECOG PS2, biomarker testing with high clinical suspicion should be considered.
Clinical trial registration: NCT02941458.
Keywords: Advanced lung cancer; Biomarker testing; National registry; Targeted therapies.
Copyright © 2025 Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MP reports grants or contracts from Bristol Myers Squibb, AstraZeneca, Merck Sharp & Dohme, Roche, Takeda, Pfizer, Boehringer Ingelheim, Amgen, Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, European Commission, Eli Lilly, F. Hoffman-La Roche, Janssen and Pierre Fabré Pharmaceuticals; consulting fees and honoraria from Bristol Myers Squibb, AstraZeneca, Merck Sharp & Dohme, Roche, Takeda, Eli Lilly, F. Hoffman-La Roche, Janssen, Pfizer and Amgen; support for attending meetings and/or travel from Bristol Myers Squibb, Astra Zeneca, Merck Sharp & Dohme, Roche, Takeda, Eli Lilly, F. Hoffman-La Roche, Janssen, Pfizer, Amgen, Boehringer Ingelheim, Pierre Fabre Pharmaceuticals and Janssen; and consulting or advisory role for AstraZeneca, Amgen, Bayer, Daiichi Sankyo, Johnson & Johnson, Pfizer, Roche, Eli Lilly, Takeda, Merck Sharp & Dohme, Bristol-Myers Squibb, Gilead, Guardant Health, Ipsen, Incyte Biosciences, Pharmacosmos, Janssen, Astellas Pharma, Aegean Pharmaceuticals. MC reports payment of honoraria from Novartis, AstraZeneca, Boehringer-Ingelheim, Roche, Bristol Myers Squibb, Eli Lilly, Merck Sharpe & Dohme, Takeda, Kyowa, Pierre Fabre Pharmaceuticals, Novocure, Sanofi, Janssen and Daiichi Sankyo and consulting or advisory role for Novartis, AstraZeneca, Boehringer-Ingelheim, Roche, Bristol Myers Squibb, Eli Lilly, Merck Sharpe & Dohme, Takeda, Pfizer, Kyowa, Sanofi and Janssen. RLC reports payment of honoraria from Takeda, AstraZeneca, Amgen, Bristol Myers Squibb, Roche and Pierre Fabre; support for attending meetings or travel from Roche, AstraZeneca, Merck Sharpe & Dohme, Takeda and Merck Serono. JBB reports honoraria for lectures from Regeneron, AstraZeneca, Sanofi, Bristol Myers Squibb, Takeda, Roche, Merck Serono and Pfizer; support for attending meetings or travel from Merck Sharpe & Dohme, Roche and Takeda and consulting or advisory role for Merck Sharpe & Dohme and Roche. KM reports payment or honoraria from Bristol Myers Squibb, Johnson & Johnson, Merck Sharpe & Dohme, Roche, Pfizer, AstraZeneca, Takeda, Merck Serono, Eli Lilly and Sanofi; support for attending meetings or travel from Roche, Johnson & Johnson, Merck Sharpe & Dohme, Takeda, Pfizer, Sanofi, Merck Serono and Bristol Myers Squibb; and participation on Data Safety Monitoring Board or Advisory Board from Roche and Merck Serono. ASH reports payment of honoraria from Roche, AstraZeneca, Merck Sharpe & Dohme, Janssen, Eli Lilly, Takeda, Merck Serono, Pfizer and Bristol Myers Squibb and support for attending meetings or travel from Roche, Merck Sharpe & Dohme, Takeda, Jansen, Pfizer and Bristol Myers Squibb. GS reports support for attending meetings or travel from Pierre Fabré Pharmaceuticals and Johnson & Johnson. MLQ reports payment or honoraria from Eli Lilly, Ipsen, Novartis, Merck Serono, Roche, AstraZeneca, Bristol Myers Squibb, Merck Sharpe & Dohme, Pfizer, Takeda and Bayer; support for attending meetings or travel from Roche, Ipsen, Merck Sharpe & Dohme, AstraZeneca, Takeda and Pfizer and participation on Advisory Board from Ipsen, Merck Serono, AstraZeneca, Bristol Myers Squibb, Merck Sharpe & Dohme, Takeda, Bayer, and Pfizer. AE reports payment of honoraria from Bristol Myers Squibb, Merck Sharpe & Dohme, Roche, AstraZeneca, PharmaMar, Amgen, Bayer, Takeda, Pfizer, GlaxoSmithKline and Johnson & Johnson; support for attending meetings and/or travel from Merck Sharpe & Dohme, PharmaMar, Deciphera, Johnson & Johnson and participation on a Data Safety Monitoring Board or Advisory Board from Roche, Merck Sharpe & Dohme, Takeda, GlaxoSmithKline and Deciphera. DR, EC, VC, RB, MFB, EB, KM, ALO, SV, MG, MB, AC and BM have no competing interest to declare.
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